Development of neurocognitive disorders in HIV/AIDS

The introduction of highly active antiretroviral therapy has had an enormous impact on the management of human immunodeficiency virus (HIV) infection and has led to an increase in survival and decrease in HIV-associated dementia. However, minor neurocognitive disturbances across various neurocognitive domains remain common in 50% or more of HIV patients according to recent estimates. Increased longevity has led to the investigation of several moderating and complicating factors, including vascular disease, neurotoxicity, aging, substance abuse, hepatitis C coinfection, and psychiatric illness. This article provides a review of the history of HIV-associated neurocognitive disorders (HAND), revised diagnostic terminology, factors moderating development of HAND, assessment techniques and neurocognitive profiles, current treatment and limitations, and future research directions.